[Leptospirosis due to occupational activity in a sewage treatment plant - case report of a recognized occupational disease].

The patient (male, two expert reports: 61 and 63 years old) experienced symptoms of a flu-like infection with rapid deterioration and cognitive complaints. He has been an employee of the municipal building yard with a sewage treatment plant for approximately 24 years.Acute renal insufficiency (creatinine 9.7 mg/dl), increased anti-Leptospira IgM antibodies and Leptospira DNA using PCR were detected. The CT neurocranium without contrast medium did not reveal any relevant abnormalities.Sepsis with multiorgan failure including a type 2 myocardial infarction and acute renal failure in the context of leptospirosis was diagnosed.Antibiotic therapies with piperacillin/tazobactam, clarithromycin and meropenem were given. Regarding acute renal failure, renal function was significantly improved by using temporary hemodialysis. After an assessment, leptospirosis was recognized as occupational disease No. 3102 in accordance with Appendix 1 of the Occupational Diseases Ordinance.Physicians should take a work history and, if there is reasonable suspicion, are legally obliged to report suspected occupational diseases. The primary infection and such a complex course (including costs) can be prevented by adequate occupational safety.